In this case report, “Exacerbation of Osteoarthritic Joint Pain by Lyme Disease,” Bennani and colleagues demonstrate the importance in identifying an underlying tick-borne infection, as appropriate treatment can dramatically improve a patient’s quality of life.¹
A 63-year-old man, who was wheelchair-bound, presented to his clinician’s office with severe pain in both knees, which had been progressively worsening over several months. He had previously undergone bilateral knee arthroscopies for meniscal tears and recently received corticosteroid injections, which did not alleviate his pain.
The authors suggest that while corticosteroids can reduce inflammation and alleviate pain, the bacterial infection can continue to proliferate and destroy knee tissue.
“Before treatment, our patient was wheelchair-bound due to the combination of existing osteoarthritis and the manifestation of Lyme disease in his knees.”
“The patient did report that he was recently on erythromycin for an upper respiratory infection (URI) and indicated that his knees felt better while he was taking erythromycin,” the authors state.
Furthermore, the patient, who worked as a chief executive officer (CEO) of a company, was an avid hunter and reported that his dog had Lyme disease.
Given that the patient’s dog had Lyme disease, Lyme IgG and Lyme IgM studies were ordered.
Testing for Lyme disease was positive and the patient began treatment with doxycycline.
“Upon completion of doxycycline therapy, our patient noted significant improvement in his knee pain,” the authors state.
His improvement was so significant that the patient no longer needed the use of a wheelchair and was able to cancel his bilateral knee replacement surgery.
Authors conclude:
- “Our patient was able to avoid a costly, high-risk surgical procedure with the detection and treatment of his Lyme disease.”
- “Lyme disease should always be a consideration in the differential diagnosis of patients who have lived or have traveled to areas that are endemic to the disease and who tend to have outdoor lifestyles.”
Related Articles:
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Lyme arthritis and periprosthetic joint infections
References:
- Bennani A Z, Chegwidden B, Lambroussis C G, et al. (April 29, 2024) Exacerbation of Osteoarthritic Joint Pain by Lyme Disease. Cureus 16(4): e59318. doi:10.7759/cureus.59318
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